Diarrhea and Steatorrhea Flashcards
defined as an increase in daily stool weight above 200 g, increased liquidity of stools, and frequency of more than three times per day.
diarrhea
Diarrhea lasting less than 4 weeks
acute
diarrhea persisting for more than 4 weeks
chronic diarrhea
major mechanisms of diarrhea
secretory
osmotic
intestinal hypermotility
tests to differentiate fecal mechanisms
fecal electrolytes
fecal osmolality
stool pH
normal total fecal osmolarity
normal fecal sodium
fecal potassium
(290 mOsm/kg)
30 mmol/L
75 mmol/L
osmotic gap equation
Osmoticgap = 290 –[2(fecalsodium + fecalpotassium)]
osmotic gap with greater than 50 mOsm/kg
osmotic diarrhea
osmotic gap with less than 50 mOsm/kg
secretory diarrhea
A fecal fluid pH of less than 5.6 indicates a malabsorption of _, causing an osmotic diarrhea.
sugars
Other causes of _ are drugs, stimulant laxatives, hormones, inflammatory bowel disease (Crohn disease, ulcer- ative colitis, lymphocytic colitis, diverticulitis), endocrine disorders (hyperthyroidism, Zollinger-Ellison syndrome, VIPoma), neoplasms, and collagen vascular disease.
secretory diarrhea
caused by increased secretion of water
secretory diarrhea
caused by poor absorption that exerts os- motic pressure across the intestinal mucosa
osmotic diarrhea
Incomplete breakdown or reabsorption of food presents _ fecal material to the large intestine, resulting in water and electrolyte _ in the large intestine
increased; retention
Common Fecal Tests for Secretory Diarrhea
Stool cultures
Ova and parasite examinations
Rotavirus immunoassay
Fecal leukocytes
Common Fecal Tests for Osmotic Diarrhea
Qualitative fecal fats
Trypsin screening
Microscopic fecal fats
Muscle fiber detection
Quantitative fecal fats
Clinitest
D-xylose tolerance test
Lactose tolerance test
Fecal electrolytes
Stool pH
Fecal osmolality
a functional disorder in which the nerves and muscles of the bowel are extra sensitive
irritable bowel syndrome (IBS)
It is the hallmark of early dumping syndrome (EDS)
Rapid gastric emptying (RGE) dumping syndrome
A gastric emptying time of less than _ minutes is considered RGE.
35
Normal gastric emptying is controlled by _
fundic tone,
duodenal feedback,
GI hormones
EDS symptoms begin _ minutes following meal ingestion.
Late dumping occurs _ hours after a meal and is characterized by weakness, sweat- ing, and dizziness
10 to 30
2 to 3
often a complication of dumping syndrome
hypoglycemia
fecal fat
steatorrhea
useful in diagnosing pan- creatic insufficiency and small-bowel disorders that cause mal- absorption
steatorrhea
sugar that does not need to be digested but does need to be absorbed to be present in the urine
D-xylose
If urine D-xylose is low, the resulting steatorrhea indicates a _
malabsorption condition
A normal D-xylose test indicates _
pancreatitis
